Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jan 7, 2008; 14(1): 125-128
Published online Jan 7, 2008. doi: 10.3748/wjg.14.125
Intermittent gastric outlet obstruction due to a gallstone migrated through a cholecysto-gastric fistula: A new variant of “Bouveret’s syndrome”
Dimitry Arioli, Ivo Venturini, Michele Masetti, Elisa Romagnoli, Antonella Scarcelli, Pietro Ballesini, Athos Borghi, Alessandro Barberini, Vincenzo Spina, Mario De Santis, Fabrizio Di Benedetto, Giorgio Enrico Gerunda, Maria Luisa Zeneroli
Dimitry Arioli, Ivo Venturini, Elisa Romagnoli, Pietro Ballesini, Athos Borghi, Maria Luisa Zeneroli, Medicina Interna II, Department of Medicine and Medical Specialties, Azienda Ospedaliera-Policlinico, Università di Modena e Reggio Emilia, Modena 41100, Italy
Michele Masetti, Fabrizio Di Benedetto, Giorgio Enrico Gerunda, Liver and Multivisceral Transplant Center, Azienda Ospedaliera-Policlinico, Università di Modena e Reggio Emilia, Modena 41100, Italy
Antonella Scarcelli, Gastrointestinal Unit, Department of Medicine and Medical Specialties, Azienda Ospedaliera-Policlinico, Università di Modena e Reggio Emilia, Modena 41100, Italy
Alessandro Barberini, Vincenzo Spina, Mario De Santis, Department of Radiology and Liver and Multivisceral Transplant Center; Azienda Ospedaliera-Policlinico, Università di Modena e Reggio Emilia, Modena 41100, Italy
Correspondence to: Dr. Ivo Venturini, Medicina Interna II, Dipartimento di Medicine e Specialità Mediche, Università di Modena e Reggio Emilia, Via del pozzo 71, Modena 41100, Italy. ivo.adsl@alice.it
Telephone: +39-59-4222237
Fax: +39-59-4222360
Received: September 3, 2007
Revised: October 15, 2007
Published online: January 7, 2008
Abstract

Bouveret’s syndrome, defined as gastric outlet obstruction due to a large gallstone, is still one of the most dramatic biliary gallstone complications. Although new radiological and endoscopic techniques have made pre-surgical diagnosis possible in most cases and the death rate has dropped dramatically, “one-stage surgery” (biliary surgery carried out at the same time as the removal of the gut obstruction) should be still considered as the gold standard for the treatment of gallstone ileus.In this case, partial gastric outlet obstruction resulted in an atypical and insidious clinical presentation that allowed us to perform the conventional one-stage laparatomic procedure that completely solved the problem, thus avoiding any further complications.

Keywords: Bouveret’s syndrome, Biliary gallstone, Gastric outlet obstruction, Biliary surgery